Bill Text: OR SB227 | 2011 | Regular Session | Introduced

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Bill Title: Relating to dental therapists; declaring an emergency.

Spectrum: Unknown

Status: (Failed) 2011-06-30 - In committee upon adjournment. [SB227 Detail]

Download: Oregon-2011-SB227-Introduced.html

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     76th OREGON LEGISLATIVE ASSEMBLY--2011 Regular Session

NOTE:  Matter within  { +  braces and plus signs + } in an
amended section is new. Matter within  { -  braces and minus
signs - } is existing law to be omitted. New sections are within
 { +  braces and plus signs + } .

LC 1561

                         Senate Bill 227

Printed pursuant to Senate Interim Rule 213.28 by order of the
  President of the Senate in conformance with presession filing
  rules, indicating neither advocacy nor opposition on the part
  of the President (at the request of Senate Interim Committee on
  Health Care for Oregon Oral Health Coalition)

                             SUMMARY

The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.

  Directs Oregon Board of Dentistry to issue certificates to
dental therapists to perform certain dental services.
  Declares emergency, effective on passage.

                        A BILL FOR AN ACT
Relating to dental therapists; creating new provisions; amending
  ORS 679.010, 679.020, 679.025, 679.253 and 680.150; and
  declaring an emergency.
Be It Enacted by the People of the State of Oregon:
  SECTION 1.  { + Sections 2 and 3 of this 2011 Act are added to
and made a part of ORS 680.010 to 680.205. + }
  SECTION 2.  { + (1) Upon application accompanied by the fee
established by the Oregon Board of Dentistry, the board shall
issue a certificate to practice as a dental therapist to an
applicant who:
  (a) Holds a valid, unrestricted dental hygiene license;
  (b) Holds a dental therapist certificate issued by a dental
therapist educational program approved by the board;
  (c) Presents documentation satisfactory to the board of
completion of coursework and training necessary to provide each
of the dental therapist services permitted under section 3 of
this 2011 Act;
  (d) Passes an examination approved by the board;
  (e) Presents proof of current professional liability insurance
coverage approved by the board; and
  (f) Presents documentation satisfactory to the board of
completion of an emergency life support course for health
professionals, including cardiopulmonary resuscitation, from an
agency or educational institution approved by the board.
  (2) A certificate issued pursuant to subsection (1) of this
section expires two years after the date of issuance unless
renewed on or before that date by:
  (a) Payment of the renewal fee established by the board;
  (b) Submission to the board of satisfactory evidence of
completion of at least 40 hours of continuing education directly
related to clinical patient care or the practice of dental public
health; and
  (c) Presentation to the board of proof of professional
liability coverage approved by the board.
  (3) The board may refuse to issue or renew a dental therapist
certificate or may suspend or revoke a dental therapist
certificate if the applicant or certificate holder:
  (a) Has been convicted of an offense or been disciplined by a
dental licensing body for an offense that bears, in the judgment
of the board, a demonstrable relationship to the ability of the
applicant or certificate holder to practice as a dental therapist
in accordance with the provisions of this chapter or chapter 679;
or
  (b) Has falsified an application for a certificate.
  (4) The board may discipline a dental therapist for any cause
described under ORS 679.140 or 679.170. + }
  SECTION 3.  { + (1) A person who holds a dental therapist
certificate issued under section 2 of this 2011 Act may perform
the following services without the supervision of a dentist:
  (a) All services within the scope of practice of dental
hygiene.
  (b) All services within the scope of practice of a limited
access permit dental hygienist;
  (c) Dental radiographs;
  (d) Pulp vitality tests;
  (e) Dental prophylaxis;
  (f) Full mouth debridement;
  (g) Providing, dispensing or administering fluoride, fluoride
varnish, antimicrobial solutions for mouth rinsing and other
non-systemic antimicrobial agents;
  (h) Prescribing or dispensing prophylactic antibiotics for
total joint replacement patients and patients at risk for
infective endocarditis;
  (i) Prescribing or dispensing nonnarcotic analgesics for pain
management;
  (j) Local anesthesia;
  (k) Nitrous oxide inhalation sedation, if the dental therapist
has a permit to administer nitrous oxide required by the board
under ORS 679.250;
  (L) Applying dental sealants;
  (m) Temporary soft relines of complete dentures for tissue
conditioning; and
  (n) Brush biopsies.
  (2) A person who holds a dental therapist certificate issued
under section 2 of this 2011 Act may perform the following
services when authorized to do so by a collaborating dentist
licensed under ORS chapter 679:
  (a) Interim therapeutic restorations for caries stabilization;
  (b) Space maintainers;
  (c) Cavity preparation and direct restoration classes I through
V;
  (d) Preformed crowns;
  (e) Pulpotomies on primary teeth;
  (f) Nonsurgical extractions of primary teeth and periodontally
diseased permanent teeth with class III mobility; and
  (g) Final impressions. + }
  SECTION 4. ORS 679.010 is amended to read:
  679.010. As used in this chapter and ORS 680.010 to 680.205,
unless the context requires otherwise:
    { - (1) 'Board' means the Oregon Board of Dentistry. - }
    { - (2) - }   { + (1) + } 'Dental assistant' means a person
who, under the supervision of a dentist, renders assistance to a
dentist, dental hygienist, dental technician or another dental
assistant or renders assistance under the supervision of a dental
hygienist providing dental hygiene.
    { - (3) - }   { + (2) + } 'Dental hygiene' means that portion
of dentistry that includes the rendering of educational,
preventive and therapeutic dental services and diagnosis and
treatment planning for such services. 'Dental hygiene' includes,
but is not limited to, scaling, root planing, curettage, the
application of sealants and fluoride and any related intraoral or
extraoral procedure required in the performance of such services.
    { - (4) - }   { + (3) + } 'Dental hygienist' means a person
who, under the supervision of a dentist, practices dental
hygiene.
    { - (5) - }   { + (4) + } 'Dental technician' means
 { - that - }   { + a + } person who, at the authorization of a
dentist, makes, provides, repairs or alters oral prosthetic
appliances and other artificial materials and devices which are
returned to a dentist and inserted into the human oral cavity or
which come in contact with its adjacent structures and tissues.
   { +  (5) 'Dental therapist' means a person who holds a dental
therapist certificate issued under section 2 of this 2011
Act. + }
  (6) 'Dentist' means a person who may perform any intraoral or
extraoral procedure required in the practice of dentistry.
  (7) 'Dentistry' means the healing art which is concerned with
the examination, diagnosis, treatment planning, treatment, care
and prevention of conditions within the human oral cavity and
maxillofacial region and conditions of adjacent or related
tissues and structures. The practice of dentistry includes but is
not limited to the cutting, altering, repairing, removing,
replacing or repositioning of hard or soft tissues and other acts
or procedures as determined by the board and included in the
curricula of dental schools accredited by the Commission on
Dental Accreditation of the American Dental Association,
post-graduate training programs or continuing education courses.
  (8) 'Direct supervision' means supervision requiring that a
dentist diagnose the condition to be treated, that a dentist
authorize the procedure to be performed, and that a dentist
remain in the dental treatment room while the procedures are
performed.
  (9) 'General supervision' means supervision requiring that a
dentist authorize the procedures, but not requiring that a
dentist be present when the authorized procedures are performed.
The authorized procedures may also be performed at a place other
than the usual place of practice of the dentist.
  (10) 'Indirect supervision' means supervision requiring that a
dentist authorize the procedures and that a dentist be on the
premises while the procedures are performed.
  (11) 'Limited access permit dental hygienist' means a dental
hygienist who renders dental hygiene services in accordance with
ORS 680.205 as authorized by a limited access permit issued by
the board pursuant to ORS 680.200.
  (12) 'State' means any state or territory of the United States
and the District of Columbia.
  SECTION 5. ORS 679.020 is amended to read:
  679.020. (1) A person may not practice dentistry without a
license.
  (2) Only a person licensed as a dentist by the Oregon Board of
Dentistry may own, operate, conduct or maintain a dental
practice, office or clinic in this state.
  (3) The restrictions of subsection (2) of this section, as they
relate to owning and operating a dental office or clinic, do not
apply to a dental office or clinic owned or operated by any of
the following:
  (a) A labor organization as defined in ORS 243.650 and 663.005
(6), or to any nonprofit organization formed by or on behalf of
such labor organization for the purpose of providing dental
services. Such labor organization must have had an active
existence for at least three years, have a constitution and
bylaws, and be maintained in good faith for purposes other than
providing dental services.

  (b) The School of Dentistry of the Oregon Health and Science
University.
  (c) Institutions of higher education listed in ORS 352.002.
  (d) Local governments.
  (e) Institutions or programs accredited by the Commission on
Dental Accreditation of the American Dental Association to
provide education and training.
  (f) Nonprofit corporations organized under Oregon law to
provide dental services to rural areas and medically underserved
populations of migrant, rural community or homeless individuals
under 42 U.S.C. 254b or 254c or health centers qualified under 42
U.S.C. 1396d(l)(2)(B) operating in compliance with other
applicable state and federal law.
  (g) Nonprofit charitable corporations as described in section
501(c)(3) of the Internal Revenue Code and determined by the
Oregon Board of Dentistry as providing dental services by
volunteer licensed dentists to populations with limited access to
dental care at no charge or a substantially reduced charge.
  (4) For the purpose of owning or operating a dental office or
clinic, an entity described in subsection (3) of this section
must:
  (a) Name an actively licensed dentist as its dental director,
who shall be subject to the provisions of ORS 679.140 in the
capacity as dental director. The dental director, or an actively
licensed dentist designated by the director, shall have
responsibility for the clinical practice of dentistry, which
includes, but is not limited to:
  (A) Diagnosis of conditions within the human oral cavity and
its adjacent tissues and structures.
  (B) Prescribing drugs that are administered to patients in the
practice of dentistry.
  (C) The treatment plan of any dental patient.
  (D) Overall quality of patient care that is rendered or
performed in the practice of dentistry.
  (E) Supervision of dental hygienists, dental assistants or
other personnel involved in direct patient care and the
authorization for procedures performed by them in accordance with
the standards of supervision established by statute or by the
rules of the board.
  (F) Other specific services within the scope of clinical dental
practice.
  (G) Retention of patient dental records as required by statute
or by rule of the board.
  (H) Ensuring that each patient receiving services from the
dental office or clinic has a dentist of record.
  (b) Maintain current records of the names of licensed dentists
who supervise the clinical activities of dental hygienists,
dental assistants or other personnel involved in direct patient
care utilized by the entity. The records must be available to the
board upon written request.
  (5) Subsections (1) and (2) of this section do not apply to
a { + :
  (a) + } Limited access permit dental hygienist who renders
services authorized by a limited access permit issued by the
board pursuant to ORS 680.200.
   { +  (b) Dental therapist who renders services authorized by
section 3 of this 2011 Act. + }
  (6) Nothing in this chapter precludes a person or entity not
licensed by the board from:
  (a) Ownership or leasehold of any tangible or intangible assets
used in a dental office or clinic. These assets include real
property, furnishings, equipment and inventory but do not include
dental records of patients related to clinical care.
  (b) Employing or contracting for the services of personnel
other than licensed dentists.

  (c) Management of the business aspects of a dental office or
clinic that do not include the clinical practice of dentistry.
  (7) If all of the ownership interests of a dentist or dentists
in a dental office or clinic are held by an administrator,
executor, personal representative, guardian, conservator or
receiver of the estate of a former shareholder, member or
partner, the administrator, executor, personal representative,
guardian, conservator or receiver may retain the ownership
interest for a period of 12 months following the creation of the
ownership interest. The board shall extend the ownership period
for an additional 12 months upon 30 days' notice and may grant
additional extensions upon reasonable request.
  SECTION 6. ORS 679.025 is amended to read:
  679.025. (1)   { - It shall be unlawful for any - }   { + A + }
person   { - not otherwise authorized by law to - }   { + may
not + } practice dentistry or purport to be a dentist
 { - without - }   { + unless the person holds  + }a valid
license to practice dentistry issued by the Oregon Board of
Dentistry.
  (2) The requirements of this section   { - shall - }
 { + do + } not apply to:
  (a) Dentists licensed in another state making a clinical
presentation sponsored by a bona fide dental society or
association or an accredited dental educational institution
approved by the board.
  (b) Bona fide full-time students of dentistry who, during the
period of their enrollment and as a part of the course of study
in an Oregon accredited dental education program, engage in
clinical studies on the premises of such institution or in a
clinical setting located off the premises of the institution if
the facility, the instructional staff and the course of study to
be pursued at the off-premises location meet minimum requirements
prescribed by the rules of the board and the clinical study is
performed under the direct supervision of a member of the
faculty.
  (c) Bona fide full-time students of dentistry who, during the
period of their enrollment and as a part of the course of study
in a dental education program located outside of Oregon that is
accredited by the Commission on Dental Accreditation of the
American Dental Association or its successor agency, engage in
community-based or clinical studies as an elective or required
rotation in a clinical setting located in Oregon if the
community-based or clinical studies meet minimum requirements
prescribed by the rules of the board and are performed under the
direct supervision of a member of the faculty of the Oregon
Health and Science University School of Dentistry.
  (d) Candidates who are preparing for a licensure examination to
practice dentistry and whose application has been accepted by the
board or its agent, if such clinical preparation is conducted in
a clinic located on premises approved for that purpose by the
board and if the procedures are limited to examination only. This
exception shall exist for a period not to exceed two weeks
immediately prior to a regularly scheduled licensure examination.
  (e) Dentists practicing in the discharge of official duties as
employees of the United States Government and any of its
agencies.
  (f) Instructors of dentistry, whether full- or part-time, while
exclusively engaged in teaching activities and while employed in
accredited dental educational institutions.
  (g) Dentists employed by public health agencies who are not
engaged in the direct delivery of clinical dental services to
patients.
  (h) Persons licensed to practice medicine in the State of
Oregon in the regular discharge of their duties.

  (i) Persons qualified to perform services relating to general
anesthesia or sedation under the direct supervision of a licensed
dentist.
  (j) Persons practicing dentistry upon themselves as the
patient.
  (k) Dental hygienists, dental assistants or dental technicians
performing services under the supervision of a licensed dentist
in accordance with the rules adopted by the board.
  (L) A person licensed as a denturist under ORS 680.500 to
680.565 engaged in the practice of denture technology.
  (m) A limited access permit dental hygienist who renders
services authorized by a limited access permit issued by the
board pursuant to ORS 680.200.
   { +  (n) A dental therapist who renders services authorized by
section 3 of this 2011 Act. + }
  SECTION 7. ORS 679.253 is amended to read:
  679.253. For the purpose of requesting a state or nationwide
criminal records check under ORS 181.534, the Oregon Board of
Dentistry may require the fingerprints of a person who:
  (1) Is employed or applying for employment by the board in a
position in which the person has or will have access to
information that is made confidential under state or federal
laws, rules or regulations;
  (2) Provides services or seeks to provide services to the board
as a contractor, vendor or volunteer in a position in which the
person has or will have access to information that is made
confidential under state or federal laws, rules or regulations;
  (3) Is applying for a license   { - or - }  { + , + } permit
 { + or certificate + } that is issued by the board;
  (4) Is applying for renewal of a license   { - or - }
 { + , + } permit  { + or certificate + } that is issued by the
board; or
  (5) Is under investigation by the board.
  SECTION 8. ORS 680.150 is amended to read:
  680.150. (1) Any dentist may employ a dental hygienist who may
engage in the practice of dental hygiene in the office of such
dentist under the general supervision of a dentist.
  (2) Any public institution, health care facility or health
maintenance organizations, as those terms are defined in ORS
442.015, may employ a dental hygienist who may engage in the
practice of dental hygiene under the general supervision of a
dentist.
  (3) A dental hygienist under the general supervision of a
dentist may engage in the practice of dental hygiene in any place
where limited access patients are located.
  (4) The Oregon Board of Dentistry may adopt rules specifying
other locations where dental hygienists may work and shall
specify in its rules the degree of supervision a dentist must
exercise over the procedures the hygienist performs.
  (5) Notwithstanding ORS 679.010   { - (4) - }  { +  (3) + },
supervision by a dentist is not required when a dental hygienist
determines the need for and appropriateness of sealants or
fluoride, and applies sealants or fluoride at the locations and
for persons described in ORS 680.205 (1) and (2).
  SECTION 9.  { + (1) Sections 2 and 3 of this 2011 Act and the
amendments to ORS 679.010, 679.020, 679.025, 679.253 and 680.150
by sections 4 to 8 of this 2011 Act become operative on January
1, 2012.
  (2) The Oregon Board of Dentistry may take any action that is
necessary to enable the board to exercise, on and after the
operative date specified in subsection (1) of this section, all
the duties, functions and powers conferred on the board by
sections 2 and 3 of this 2011 Act and the amendments to ORS
679.010, 679.020, 679.025, 679.253 and 680.150 by sections 4 to 8
of this 2011 Act. + }

  SECTION 10.  { + This 2011 Act being necessary for the
immediate preservation of the public peace, health and safety, an
emergency is declared to exist, and this 2011 Act takes effect on
its passage. + }
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